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PostPosted: Wed Jan 03, 2018 12:03 pm 
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A blog post that describes Massachusetts use of 72 hour holds for substance use. It lacks any input or interviews of anyone that has actually been subjected to it. Is 72 hours enough? If withdrawal is aggressively treated and MAT offered would people respond? A new approach that needs a robust research approach to see if it actually helps. As one of the commentators wondered, will it cause more harm?

Is blog post redundant? I'm full of questions today.


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PostPosted: Sun Jan 07, 2018 5:43 pm 
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I once worked in a county ER where we would see the same alcoholics each night, hold them until BAC was below 0.02, then discharge them to drink again. I wondered why we couldn't hold them against their will.

Now I know why. Yes, active addicts always have some degree of ambivalence. But 72 hours is not near long enough to tap into the ambivalence. If you held them for 2 months you might get half to buy into treatment. Of those, most would go back to using within days of being back in the using world again. That sounds pessimistic, I know, but you could put a positive spin on it and recognize the indefatigability of the human spirit-- even when directed toward self destruction.

People must be ready for treatment, at least from what I've seen. I've seen people who should be very desperate, who turn down gold-plated treatment. And I've met people who have no resources at all, yet found a way get straight.

I recognize that I'm becoming more cynical... unfortunately many people addicted to opioids are now coming in addicted to cocaine (crack or IV) and/or methamphetamine. MUCH harder to treat than the people who had pain pills run up.


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

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